Summary

This is a brief report to provide a summary of results from the post-covid-events analyses performed in OpenSAFELY. Cohorts = Pre-Vaccination Outcome = Diabetes (Type-2, Type-1, Unspecified). PLEASE NOTE that these results are preliminary and subject to change.

Cohorts relative to vaccine introduction and variants

Data downloaded as CSV from here N.B.includes B, Alpha, Delta and Omicron variants. Data additionally downloaded from here for pre-September-2020 case estimates before variant monitoring was present.

Cohort selection flow charts

Pre-vaccinated Cohort Flow

Vaccinated Cohort Flow

Unvaccinated Cohort Flow

Table: Patient characteristics of those without COVID history for each cohort and numbers of people who were exposed to COVID-19.

Covariate Covariate Level Prevax Population Prevax Number diagnosed with COVID 19 risk per 100 000 Vax Population Vax Number diagnosed with COVID 19 risk per 100 000 Unvax Population Unvax Number diagnosed with COVID 19 risk per 100 000
All All 15175714 826582 (5447) 11789177 749030 (6354) 2859217 147221 (5149)
sex Female 7661354 450927 (5886) 6215420 422129 (6792) 1175305 78623 (6690)
sex Male 7514360 375655 (4999) 5573757 326901 (5865) 1683912 68598 (4074)
ethnicity White 11903511 620076 (5209) 9707785 638738 (6580) 1779237 112236 (6308)
ethnicity Mixed 172865 11633 (6730) 106623 6461 (6060) 69993 3656 (5223)
ethnicity South Asian 898418 91607 (10196) 602213 31935 (5303) 275991 9083 (3291)
ethnicity Black 310993 21368 (6871) 172488 7751 (4494) 147557 7089 (4804)
ethnicity Other 324162 16366 (5049) 197166 9022 (4576) 160219 3869 (2415)
ethnicity Missing 1565765 65532 (4185) 1002902 55123 (5496) 426220 11288 (2648)
deprivation 1-2 (most deprived) 2884715 199770 (6925) 1855885 112614 (6068) 853767 44237 (5181)
deprivation 4-Mar 2979353 178027 (5975) 2178752 135956 (6240) 686486 34821 (5072)
deprivation 6-May 3270564 165138 (5049) 2608923 161359 (6185) 572151 29274 (5116)
deprivation 8-Jul 3125930 151191 (4837) 2608726 168320 (6452) 436022 22481 (5156)
deprivation 9-10 (least deprived) 2915152 132456 (4544) 2536891 170781 (6732) 310791 16408 (5279)
region East 3573633 190145 (5321) 2803397 161606 (5765) 651907 34026 (5219)
region East Midlands 2660822 157083 (5904) 2062410 138181 (6700) 469981 28224 (6005)
region London 953066 52592 (5518) 601019 31973 (5320) 402794 10645 (2643)
region North East 745041 50517 (6780) 570462 43106 (7556) 123655 7181 (5807)
region North West 1351813 89454 (6617) 1061351 75200 (7085) 194470 11823 (6080)
region South East 1012424 41114 (4061) 826297 50120 (6066) 172818 8829 (5109)
region South West 2137597 63752 (2982) 1838482 113835 (6192) 286399 17461 (6097)
region West Midlands 576450 42844 (7432) 399351 24838 (6220) 148932 7454 (5005)
region Yorkshire and The Humber 2164868 139081 (6424) 1626408 110171 (6774) 408261 21578 (5285)
smoking status Never smoker 7088744 422829 (5965) 5619699 371342 (6608) 1178313 59118 (5017)
smoking status Ever smoker 4781706 250809 (5245) 4107299 280313 (6825) 560552 42410 (7566)
smoking status Current smoker 2650985 115959 (4374) 1668733 82264 (4930) 785342 37154 (4731)
smoking status Missing 654279 36985 (5653) 393446 15111 (3841) 335010 8539 (2549)
bmi groups Missing 2477686 147710 (5962) 1498710 75454 (5035) 895225 32732 (3656)
bmi groups Healthy_weight 4806928 231382 (4814) 3730127 229980 (6165) 931142 46758 (5022)
bmi groups Underweight 283648 13039 (4597) 203769 9397 (4612) 80957 3419 (4223)
bmi groups Overweight 4451907 234464 (5267) 3680896 239204 (6499) 587603 35693 (6074)
bmi groups Obese 3155545 199987 (6338) 2675675 194995 (7288) 364290 28619 (7856)
age group 18-29 2766105 216349 (7821) 1572826 84052 (5344) 881360 40039 (4543)
age group 30-39 2813879 183955 (6537) 1772688 134877 (7609) 876730 51058 (5824)
age group 40-49 2682572 168528 (6282) 1979944 214431 (10830) 550325 33775 (6137)
age group 50-59 2755651 154407 (5603) 2344031 179121 (7642) 321822 16044 (4985)
age group 60-69 1996255 66053 (3309) 1867109 85034 (4554) 145286 4621 (3181)
age group 70-79 1492285 25991 (1742) 1512358 39359 (2602) 59091 1206 (2041)
age group 80-89 585198 8852 (1513) 627148 10279 (1639) 19754 405 (2050)
age group 90+ 83769 2447 (2921) 113073 1877 (1660) 4849 73 (1505)
consulation rate group 0 4251535 188009 (4422) 2926673 170113 (5813) 1550844 45547 (2937)
consulation rate group 1 to 6 5957458 347783 (5838) 4812285 320995 (6670) 804368 57319 (7126)
consulation rate group 6+ 4966721 290790 (5855) 4050219 257922 (6368) 504005 44355 (8801)
consulation rate Mean 5 6 (107972) 6 5 (99565) 3 5 (167146)
tc hdl ratio Mean 4 4 (95000) 4 4 (92500) 4 4 (99211)
History of all stroke TRUE 176279 6243 (3542) 184967 6463 (3494) 10048 548 (5454)
History of ami TRUE 248660 8571 (3447) 252988 9412 (3720) 12901 684 (5302)
History of angina TRUE 384477 12426 (3232) 381653 13802 (3616) 15388 810 (5264)
History of cancer TRUE 4581503 282844 (6174) 4091955 321575 (7859) 542092 50801 (9371)
History of carehome status TRUE 25655 3972 (15482) 29267 1378 (4708) 2000 70 (3500)
History of chronic kidney disease TRUE 637649 21221 (3328) 654909 22271 (3401) 30240 1777 (5876)
History of chronic obstructive pulmonary disease TRUE 374624 12697 (3389) 368930 13582 (3681) 20837 1001 (4804)
History of dementia TRUE 81044 5399 (6662) 94867 2915 (3073) 3017 154 (5104)
History of depression TRUE 4212896 239556 (5686) 3494127 239874 (6865) 631362 47049 (7452)
History of diabetes gestational TRUE 82980 6448 (7771) 75904 8444 (11125) 22478 2561 (11393)
History of healthcare worker TRUE 480633 55407 (11528) 414767 33701 (8125) 17582 2084 (11853)
History of hf TRUE 180577 6366 (3525) 204741 7166 (3500) 8572 476 (5553)
History of hypertension TRUE 4358003 201059 (4614) 4e+06 212405 (5311) 372096 27135 (7292)
History of liver disease TRUE 85527 3951 (4620) 78270 3746 (4786) 12788 651 (5091)
History of other arterial embolism TRUE 68884 2692 (3908) 83968 3513 (4184) 4914 281 (5718)
History of prediabetes TRUE 731601 30118 (4117) 821101 35836 (4364) 52224 3352 (6419)
History of vte TRUE 216641 9425 (4351) 214363 11133 (5194) 21533 1662 (7718)

Table: Numbers of events in OpenSAFELY before and after diagnosis of COVID-19.

To be completed.

Figure: Maximally adjusted hazard ratios (log scale) for different diabetes events by time since diagnosis of COVID-19.

N.B. There were too few events for Other or Non-Specific Diabetes in the Unvaccinated Cohort.

Figure: Maximally adjusted hazard ratios (log scale) for Type-2 Diabetes by time since diagnosis of Hospitalised / Non-Hospitalised COVID-19.

Figure: Maximally adjusted hazard ratios (log scale) for Type-2 Diabetes by time since diagnosis of COVID-19 for Age, Sex and Ethnicity Subgroups.

N.B. Results not shown for any subgroup with too few events according to criteria set out in the pre-specified analysis plan

Figure: Maximally adjusted hazard ratios (log scale) for Type-2 Diabetes by time since diagnosis of COVID-19 (full time points).

N.B. Full time point results were not ran in the unvaccinated cohort due to the number of events.

Figure: Maximally adjusted hazard ratios (log scale) for Type-2 Diabetes by time since diagnosis of COVID-19 for Stratified by History of Obesity or Pre-Diabetes.

Diabetes flow charts: showing the assignment of diabetes cases using the diabetes diagnostic algorithm.

All values have been rounded to the nearest multiple of 7 to avoid potential disclosure and back-calculation.

Prevaccinated Cohort.

Vaccinated Cohort.

Unvaccinated Cohort.

Table: Describing the number of Type-2 Diabetes cases diagnosed in each cohort throughout the study period using numbers from the diabetes flow charts.

Measure Prevaccinated Vaccinated Unvaccinated
Duration (days) 535 197 197
Sample Size 15176232 12752330 3095271
Type 2 Diabetes cases during study period (N) 184800 83902 6839
Type 2 Diabetes cases during study period (%) 1.22 0.66 0.22
Averaged number of Type 2 Diabetes diagnoses per day 345 425 35